An unusual presentation of a depressed clavicle fracture in a child leading to venous congestion

Clavicle fractures are common in children, comprising up to 15% of fractures presenting to the emergency department. Typically, mid-shaft clavicle fracture in the paediatric population is managed conservatively, with surgery recommended in a select few. A 12-year-old boy presented with a depressed mid-shaft clavicle fracture with an ipsilateral cervical rib exhibiting features of venous congestion. This case was managed conservatively using a sling and the patient was admitted for overnight observation with early mobilisation encouraged. His recovery was complicated by a re-fracture 4 weeks later, which was managed conservatively with a good clinical outcome. This is the first report of such a fracture associated with an ipsilateral cervical rib. This case highlights that such injuries with vascular concerns could be managed conservatively with good outcomes.